Imaging characteristics of cardiac metastases in patients with malignant melanoma

Abstract

BackgroundDue to prolonged survival and technical advances in CT imaging, cardiac metastases in patients with malignant melanoma are observed more frequently nowadays. The aim of the present study was to assess the anatomic distribution as well as the morphologic and histologic appearance of cardiac metastases from malignant melanoma.MethodsTwenty five patients with known metastasized melanoma and with incidental finding of cardiac metastases during routine staging CT were retrospectively included in this study. CT images were assessed for the presence, localization and extent of cardiac metastases. Histological results, mutational analysis and tumor markers were reviewed.ResultsFourteen out of 25 patients presented with singular cardiac mass (56%), whereas ten patients (40%) presented with multifocal and one patient with disseminated cardiac metastases. Twelve patients presented with endocardial (48%), eight with myocardial and two with pericardial metastases. Most frequent site involved in endocardial metastases was the right atrium (67%) followed by the right ventricle (33%). There seems to be a correlation between histological subtype and location of cardiac metastasis. Median survival after diagnosis of cardiac metastases was 8 months, with no significant difference regarding the localization of metastases within the heart.ConclusionCardiac metastases can involve every part of the heart possibly in dependence of histological subtype. The awareness of different types of cardiac metastases and their characteristic appearance on CT images is necessary for further investigations and might contribute to targeted therapy.

Intracardiac melanoma metastases on 18F-FDG PET-CT—a case report and review of literature with imaging features

“…Cardiac metastases are rarely diagnosed on routine staging scans for melanoma as they are often asymptomatic and can evade detection due to motion artefacts on CT 2,3 the modality most commonly used for staging. Cardiac invasion usually occurs due to lymphatic and haematogenous spread and depends on individual aspects affecting histology and functional environment of melanoma cells.…”

“…Cardiac invasion usually occurs due to lymphatic and haematogenous spread and depends on individual aspects affecting histology and functional environment of melanoma cells. 2…”

“…Cutaneous malignant melanoma, an aggressive neoplasm 1 with increasing incidence, has a higher propensity to metastasize to the heart compared to other tumours. 2,3 However, they are rarely detected ante-mortem due to paucity of specific symptoms and signs. 3…”

Differentiation of Primary Cardiac Tumors from Metastatic Tumors by Non-invasive Cardiac Imaging

“…Iodinated contrast material was intravenously injected using an automatic power injector. CT was performed without ECG synchronism, except for one lesion (13,18).…”

“…In contrast, systemic chemotherapy applies in patients with cardiac metastases. Some patients have surgical resection, or palliative care (12)(13)(14)(15). Although it is important to distinguish between primary cardiac and metastatic cardiac masses, currently there are limited diagnostic approaches (16,17).…”